School of Population Health, University of Auckland, 28 Park Ave, Auckland, 1023, New Zealand.
Auckland Sexual Health Regional Service, Auckland District Health Board, Auckland, New Zealand.
AIDS Behav. 2022 Aug;26(8):2723-2737. doi: 10.1007/s10461-022-03617-5. Epub 2022 Feb 15.
Inequities in pre-exposure prophylaxis (PrEP) experiences will impede HIV epidemic elimination among gay and bisexual men (GBM). Ethnicity is a strong marker of inequity in the United States, but evidence from other countries is lacking. We investigated experiences on-PrEP to 12 months follow-up in a prospective cohort of 150 GBM in Auckland, New Zealand with an equity quota of 50% non-Europeans. Retention at 12 months was 85.9%, lower among Māori/Pacific (75.6%) than non-Māori/Pacific participants (90.1%). Missed pills increased over time and were higher among Māori/Pacific. PrEP breaks increased, by 12 months 35.7% of Māori/Pacific and 15.7% of non-Māori/Pacific participants had done so. Condomless receptive anal intercourse partners were stable over time. STIs were common but chlamydia declined; 12-month incidence was 8.7% for syphilis, 36.0% gonorrhoea, 46.0% chlamydia, 44.7% rectal STI, 64.0% any STI. Structural interventions and delivery innovations are needed to ensure ethnic minority GBM gain equal benefit from PrEP.Clinical trial number ACTRN12616001387415.
在接受暴露前预防 (PrEP) 的经验方面存在不平等现象，这将阻碍男同性恋和双性恋者 (GBM) 中艾滋病毒的流行消除。种族在美国是不平等的一个重要标志，但其他国家的证据却缺乏。我们调查了在新西兰奥克兰的一项前瞻性队列研究中，150 名 GBM 在接受 PrEP 后 12 个月的经验，其中非欧洲裔的权益配额为 50%。12 个月的保留率为 85.9%，毛利/太平洋岛民（75.6%）的保留率低于非毛利/太平洋岛民参与者（90.1%）。错过的药丸随着时间的推移而增加，毛利/太平洋岛民的比例更高。PrEP 中断增加，到 12 个月时，35.7%的毛利/太平洋岛民和 15.7%的非毛利/太平洋岛民参与者已经这样做了。无保护的接受性肛交伴侣在一段时间内保持稳定。性传播感染很常见，但衣原体减少；12 个月时梅毒的发病率为 8.7%，淋病为 36.0%，衣原体为 46.0%，直肠性传播感染为 44.7%，任何性传播感染为 64.0%。需要进行结构性干预和交付创新，以确保少数民族 GBM 从 PrEP 中获得平等的益处。临床试验编号 ACTRN12616001387415。
